Certified Healthcare Protection Administrator CHPA Application
This file contains essential information regarding the CHPA application process. It outlines eligibility requirements, instructions for submission, and necessary documents. Healthcare security professionals can use this file to obtain the CHPA certification.
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How do I fill this out?
To fill out this application, carefully read the instructions provided. Ensure you document all required information clearly. Finally, attach necessary documentation as specified in the application.

How to fill out the Certified Healthcare Protection Administrator CHPA Application?
1
Read the application thoroughly and understand the eligibility requirements.
2
Complete the application form in its entirety including required documentation.
3
Attach necessary supporting documents such as diplomas and letters of experience.
4
Sign and date your application where indicated.
5
Submit the completed application with the required fee by your chosen method.
Who needs the Certified Healthcare Protection Administrator CHPA Application?
1
Healthcare security professionals seeking certification.
2
HR personnel in healthcare facilities needing to verify qualifications.
3
Individuals applying for management positions in healthcare security.
4
Education institutions offering healthcare security programs.
5
Professional organizations that provide training in healthcare safety.
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What are the instructions for submitting this form?
To submit your CHPA application, choose between mail, fax, or email. For mail, send your application to IAHSS at 8420 W. Bryn Mawr Ave., Suite 1020, Chicago IL 60631. You may also fax to 630-529-4139 or email directly to Nancy@IAHSS.org. Ensure all documents are attached to prevent processing delays.
What are the important dates for this form in 2024 and 2025?
The CHPA application deadlines may vary, so check regularly for updates. For 2024, applications will be accepted year-round, while renewals will follow an established timeline. Ensure to submit within 90 days of your renewal date.

What is the purpose of this form?
This form is designed to facilitate the certification process for healthcare security professionals. It provides a structured approach to document qualifications and experiences required for certification. By completing this form, applicants affirm their commitment to the highest standards in healthcare security.

Tell me about this form and its components and fields line-by-line.

- 1. Applicant Name: Enter your full name as it appears on official documents.
- 2. Mailing Address: Provide your current mailing address.
- 3. Email Address: Input your primary email for future correspondence.
- 4. Phone Number: List your primary contact number.
- 5. Employment History: Document relevant work experience with supporting letters.
What happens if I fail to submit this form?
Failure to submit the form correctly may result in delays or denial of your application. Make sure to follow all instructions carefully to ensure your application is processed in a timely manner.
- Incomplete Applications: Any application missing required information will be returned.
- Missing Documentation: Lack of supporting documentation will lead to application denial.
- Late Submission: Submitting after the renewal deadline can result in additional fees.
How do I know when to use this form?

- 1. When applying for certification: This form is essential for obtaining your CHPA certification.
- 2. When renewing certification: Use this application to renew your certification every three years.
- 3. When changing personal information: If you need to update any personal details, this form is required.
Frequently Asked Questions
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What do I do if my application is denied?
If denied, you'll receive an explanation along with your application and attachments.
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You can generate a shareable link or email the PDF directly from PrintFriendly.
Is there a fee for submitting the application?
Yes, the application fee is $450 for members and $525 for non-members.
How long does the application evaluation take?
Allow approximately 45 days for the evaluation of your application.
Can I save my edits on PrintFriendly?
You can download your edited PDF after making changes.
What documents are required for application?
Documents include membership proof, educational diplomas, and letters of experience.
How do I submit my completed application?
You can submit it via mail, fax, or email to the specified address.
Is there a minimum membership requirement?
No, there is no minimum membership requirement for the application.
What happens after I submit my application?
You will receive notification regarding the approval and next steps.
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